Abstract
A 73-year-old woman underwent esophagogastroduodenoscopy (EGD) at a local hospital, which revealed a flat elevated lesion, approximately 15 mm in diameter, in the posterior wall of the lower gastric body. At our hospital, a repeat EGD and biopsy led to a diagnosis of moderately dysplastic adenoma. The patient requested endoscopic submucosal dissection (ESD). Histopathology revealed a gastric adenoma with negativity for tumor at the vertical margin; however, the horizontal margin was positive for cancer with an undifferentiated carcinoma surrounding the adenoma. EGD was repeated, and a discolored area was found around the ESD scar. Biopsy revealed an undifferentiated carcinoma. Laparoscopic distal gastrectomy was performed, and postoperative histopathology also revealed an undifferentiated carcinoma (50 mm in diameter) surrounding the ESD scar; this lesion was an undifferentiated adenocarcinoma that was colocalized with and spread out to surround the original adenoma. This case is important for consideration of the pattern of development and progression of superficial spreading gastric cancer.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Tokunaga M, Ohyama S, Fujimoto Y, Hiki N, Fukunaga T, Yamamoto N, et al. Simultaneous adenocarcinoma and leiomyoma of the stomach presenting as a collision tumor. Clin J Gastroenterol. 2009;2:394–7.
Kleist B, Lasota J, Miettinen M. Gastrointestinal stromal tumor and gastric adenocarcinoma collision tumors. Hum Pathol. 2010;41:1034–9.
Morishita Y, Sugitani M, Sheikh A, Nemoto N, Fujii M, Takayama T. Collision tumor of the stomach: a rare case of an adenocarcinoma and carcinoid tumor. Arch Pathol Lab Med. 2005;129:407–9.
Pai SA, Kher N, Krishnamurthy S. Collision tumor with three components at esophagogastric junction. Indian J Gastroenterol. 1997;16:116.
Yao T, Fujiwara T, Watanabe H, Koga Y, Okada Y, Okabe H. Endoscopic diagnosis of expansion of gastric cancer. Stomach Intest. 1972;7:725–38 (in Japanese with English abstract).
Yao T, Mizoguchi M, Okada M, Imamura K, Nakamura S, Maeda K, et al. Endoscopic findings of early gastric cancer and comparison in resected specimens. Stomach Intest. 1988;23:55–66 (in Japanese with English abstract).
Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Immunol Scand. 1965;64:31–49.
Kedika RR, Souza RF, Spechler SJ. Potential anti-inflammatory effects of proton pump inhibitors: a review and discussion of the clinical implications. Dig Dis Sci. 2009;54:2312–7.
Handa O, Yoshida N, Imamoto E, Tomatsuri N, Ishikawa T, Takagi T, et al. Anti-inflammatory actions of proton pump inhibitors (PPI). Ulcer Res. 2001;28:217–9 (in Japanese with English abstract).
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Horiuchi, Y., Fujisaki, J., Shimizu, T. et al. Extensive 0-IIc (undifferentiated carcinoma) lesion around a gastric adenoma: a case report. Clin J Gastroenterol 6, 221–225 (2013). https://doi.org/10.1007/s12328-013-0383-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12328-013-0383-0